Bluebird Care (Stroud and Cirencester)

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence.

At our last assessment we rated this key question good. At this assessment the rating has changed to outstanding. This meant people’s outcomes were consistently better than expected compared to similar services. People’s feedback described it as exceptional and distinctive.

This service scored 88 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them.

The registered manager ensured care plans reflected people’s needs accurately by reviewing people’s care, auditing care plans, completing spot checks, reviewing feedback from people and their relatives and regular supervision with staff.

Staff told us changes to people’s needs were reflected well. 1 staff member said, “These [care plans] are not static, they are constantly being updated. We have annual reviews where we check everything but the most important thing is that we are continuously reviewing the care plans.” Another staff member told us, “[staff member] is mainly responsible for going out to the customer's houses, risk assessing, working out the tasks and working out their history. They all have input into the care plans and I know that they go in and change things. For example, if a new customer is identified that they need laundry added as an additional task then we can request that the task be added in to the system. We all have input on making changes and communication of new tasks added will be notified on the system so everyone is aware.”

People and their relatives also told us staff were knowledgeable in recognising when people needed additional support or making referrals to other agencies for equipment. 1 relative told us, “They [manager] came to the house and also we see someone once a year they come to the house. They ask us what we need. It started with shopping. When we needed more help, we planned it together.” And another relative told us, “They’ve been very helpful in suggesting different aids that help with [relative’s] memory - white boards; dementia clock.”

The provider always planned and delivered people’s care and treatment with them, including what was important and mattered to them. They did this in line with legislation. They worked to develop evidence-based good practice and standards.

Staff worked with people who had advancing dementia, and were skilled in understanding the person’s life story and delivering person centred care. Staff used their skills to build trust, reduce anxiety and offer meaningful conversation. Staff were able to meet the person’s psychological needs using a well-established person-centred dementia framework. This included reaffirming the person’s identity, relationships, occupation and inclusion. Staff were confident in identifying people’s unmet needs and knew what signs to look out for. For example, increased anxiety or changes with nutrition and hydration. Staff worked proactively to address these unmet needs with family and health professionals by ensuring there was a clear record of any changes and communication.

For 1 person this robust care provision reduced the amount of falls the person had, supported them to maintain adequate food and fluid intake and enabled the person to continue to live in their own home in an environment that was familiar to them.

Staff developed exceptionally positive relationships with people and their families through skilled communication and a comprehensive understanding of the person’s dementia, psychological and physical needs. This gave the family added reassurance their family member was not only safe, but able to live a good quality of life in their own home, as they wished.

Professionals told us how staff worked to reduce people’s care packages and improve their quality of life. 1 professional working with the service told us “I worked with Bluebird recently to reduce a care package down from 3x carers to 2x carers, providing equipment and advice and information to help support carers and the client.”

A relative told us how well staff understood and worked with people’s complex needs, supporting families to care for their loved ones also. “They have lots of different things and together they’re very complex when all these needs come together… They know what they’re doing with all of their needs. They teach us as well. All the time I’m learning from them.”

The provider always worked well across teams and services to support people. They shared thorough assessments of people’s needs when they moved between different services, so people only needed to tell their story once.

The provider had an effective system in place for sharing information. They used their electronic systems alongside regular feedback and supervision. Staff used an app on their phone for communicating people’s needs, changes and access to people’s care plans. If a health professional needed to view people’s care notes they could access this by scanning the QR code with their phone. This helped prevent delays in information sharing between agencies involved in the person’s care.

Staff also had direct access to a GP electronic service which provided important updates to people’s medication. This helped to minimise errors with medication administration by giving updates in real time.

Comments from staff included, “We have really good communication between the team. We have all worked together for a long time as well. We do debriefs at the end of the day verbally which are written on the notes as well. All supervisors share an office which helps communication as well” and “We have direct contact with GP connect and we can see medication updates. We can check the mediation on there.”

People and their relatives told us, “I would say the app is excellent. …I have full visibility of what’s happened… Bluebird are very good at phoning me if there are any concerns…I would describe it as excellent”.

The provider supported people to manage their health and wellbeing to maximise their independence, choice and control. Staff supported people to live healthier lives and where possible, reduce their future needs for care and support.

Staff supported people with a range of needs and health conditions. They were proactive in identifying people’s strengths and where people may benefit from other professionals input. The electronic care system staff used provided prompts to complete around areas such as skin integrity. This enabled staff to share information with the office staff in real time, who would then refer to other health professionals as appropriate.

1 staff member told us, “The carers are really good at spotting these changes and creating an alert on the system to the office where we can check and spot themes and find solutions. We always speak to the carers as well.” Another staff member told us, “We tend to call the office or on call. We put it on the PASS system and there is always a skin integrity task on the system. I call the office to talk about it.”

The provider monitored all people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, and that they fully met both clinical expectations and the expectations of people themselves.

Staff demonstrated a good awareness of people’s need and how to monitor and adapt care to improve outcomes for people.

Staff monitored and evaluated outcomes related to people’s health and quality of life, with a view to improving these outcomes when possible. In one instance, a change to a person’s moving and handling routine had resulted in a positive impact on their wellbeing and confidence and increasing their independence. The process was overseen by the care manager and an occupational therapist from the local health partnership who ensured staff were fully competent in ways of working with the person. Regular check ins with the person reaffirmed the changes were working and continued to have a positive impact.

Staff told us about the process they followed where they recognised changes to a person’s needs and how they would work with professionals and the person to improve people’s experiences. 1 staff member told us, “If the customer has a fall for example we will be informed by the carer via telephone call. We call the family as well. If they live far away we try to cover the rest of the round of the carer so they stay with the customer until the ambulance gets there. We gather as much information as we can to investigate and we document everything on the incident forms. If there is anything that needs following up i.e. and OT assessment we would put in a referral, we liaise with GPs. Communication is good.”

People and their relatives spoke about how staff went above and beyond in some situations when supporting people. 1 relative told us “We always have a debriefing…If anything happens during the visit…and put it on the alert list… they had pneumonia. They saw that they were going blue and phoned an ambulance. They see things I can’t see.’

People and their relative spoke about how the manager and their staff team would through knowing the person well make suggestions that would improve people’s outcomes.A relative told us, “Yes in the main. I had a good chat with the [manager] about the lifting cushion…They’re all extremely warm, very personable and easy to deal with. The [manager] was great the other day about the lifting cushion. They had obviously done a lot of research on that for me.”

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment.

Care plans and daily notes reflected conversations staff had with people and their relatives around consent to care. Staff we spoke with understood the importance of respecting people’s wishes.

Staff had been trained in the mental capacity act 2005 and how to apply it. Staff comments included, “We had in person and online training around MCA. We ensure we gain consent and talk through everything that we do. We ensure we support people to make their own decisions i.e. having a shower” and “I will let them do what they need to do but I will advise in their best interest. If I notified that they ask for something regularly I will add this to the notes for other carers to be aware of.”

People and their relatives told us staff were respectful of the person’s wishes and right to refuse, they explained staff approach was important. 1 relative told us, “They always tell him what they’re going to do …[they ask] is this alright.’’ Another relative told us, “I think that they do ask for permission for anything and just gently encourage them. As they’ve built that relationship with the carers, they’ve been able to do all those things now.”